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Author: Luigi Canullo
Publisher: Quintessenza
ISBN: 9788874921669
Category : Medical
Languages : en
Pages : 0
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Book Description
This multi-contributed textbook covers topics ranging from basic aspects of implant dentistry to advanced concepts such as platform switching, immediate implant placement, and the use of piezoelectric surgery for implant osteotomies. It begins with a review of the systemic, local, and surgical factors affecting bone remodeling. Next, flap design and peri-implant tissue stability are discussed in relation to the concepts of gingival biotype and biologic width. The novel concept of minimally invasive implant site preparation using piezoelectric surgical techniques is presented, followed by three chapters devoted to the theoretical and practical aspects of platform switching. Subsequent chapters address implant-abutment connection configurations and how they affect peri-implant bone remodeling as well as other prosthetic aspects of implant dentistry, including preparation design, finish lines, emergence profiles, and the shoulderless abutment. Bringing all of these concepts together, a comprehensive minimally invasive prosthetic protocol as well as a more specific shoulderless one- abutment protocol are described and illustrated with clinical cases. The final chapter examines plasma cleaning of titanium implants as a method of reducing osseointegration time and improving soft tissue response.
Author: Luigi Canullo
Publisher: Quintessenza
ISBN: 9788874921669
Category : Medical
Languages : en
Pages : 0
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Book Description
This multi-contributed textbook covers topics ranging from basic aspects of implant dentistry to advanced concepts such as platform switching, immediate implant placement, and the use of piezoelectric surgery for implant osteotomies. It begins with a review of the systemic, local, and surgical factors affecting bone remodeling. Next, flap design and peri-implant tissue stability are discussed in relation to the concepts of gingival biotype and biologic width. The novel concept of minimally invasive implant site preparation using piezoelectric surgical techniques is presented, followed by three chapters devoted to the theoretical and practical aspects of platform switching. Subsequent chapters address implant-abutment connection configurations and how they affect peri-implant bone remodeling as well as other prosthetic aspects of implant dentistry, including preparation design, finish lines, emergence profiles, and the shoulderless abutment. Bringing all of these concepts together, a comprehensive minimally invasive prosthetic protocol as well as a more specific shoulderless one- abutment protocol are described and illustrated with clinical cases. The final chapter examines plasma cleaning of titanium implants as a method of reducing osseointegration time and improving soft tissue response.
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Languages : en
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BACKGROUND : The health of the periimplant tissues play an important in the long term outcome of dental implants. Bone and soft tissue remodeling can also be influenced by dental implant materials, designs and surface modifications1. Several studies on implants with the same design but with different surfaces such as hybrid implants are lacking at the present time2. Aim: The purpose of this preliminary prospective study was to investigate the influence of soft and hard tissue response to a hybrid dental implant with a platform switch inserted at 6 months after implantation in the posterior mandible.MATERIALS AND METHODS:From August 2016 to January 2017, 16 consecutive patients were enrolled (8 men and 8 women; mean age 51.2 years with 32 implants, needing two implant-supported restoration in the posterior mandible. An impression was taken 6 weeks later, and a finall restoration was positioned. Follow-up examinations, clinical parameters, photographs, and intraoral digital radiographs were made at baseline and six month after definitive restorations to evaluate the marginal bone level changes. Cast analysis were performed to detect soft tissue vertical and horizontal changes. Implant stability was measured with an (Osstellu00ae) ISQ implant stability meter.RESULTS: Postoperative healing was uneventful. All implants were clinically osseointegrated. Changes of marginal bone level and soft tissue dimensions were recorded at implant installation and at 6 months. No bone defect around implants and there were no signs of inflammation. Soft tissue levels significantly improved between baseline and 6 month follow up. Periodontal parameters never exceeded the physiological levels. The ISQ readings obtained the high stability at 6 month follow up.CONCLUSIONS: Within the limitations of this prospective study, the analyzed hybrid implants obtained favorable results in the posterior mandible. Long term randomized controlled clinical trials on hybrid implants are necessary to confirm these results.
Author: Luigi Canullo
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Background: To prevent esthetic failures in the esthetic area, two different strategies have been proposed: a.timmediate restoration of post-extraction site using bone-level implant in association to site regeneration plus connective tissue graft, or b.tdelayed tissue-level implant insertion in association with GBR.Presence of the IAJ at the bone level, crown overlapping, need for a supplementary surgery (immediate approach) and risk of titanium divergent implant neck exposure (delayed approach) represent drawbacks to compensate post-extraction tissue shrinkage.Aim: The purpose of this prospective cohort study was to investigate, over a 36-month period, hard and soft tissue response to a different approach for replacing missing teeth in the anterior esthetic area: transmucosal implant presenting a convergent collar inserted in regenerated post-extraction site.Materials & Methods: From June 2013 to Jan 2014, all consecutive patients needing an implant supported restoration in the aesthetic anterior maxillary area between canines were enrolled. Six months after hopeless tooth extraction and alveolar socket graft with a Magnesium-enriched Hydroxyapatite, a transmucosal type implant with convergent walls collar was midcrestaly inserted with a semi-flapless surgery. Immediate provisional restoration was inserted. Two months thereafter, an impression was taken and a definitive zirconia abutment with a provisional restoration was positioned. Two weeks after, the definitive metal-free restoration was seated. Clinical parameters, pictures, radiographs and impressions were taken at the definitive restoration time point and after 6 (T1), 18 (T2) and 36 (T3) months.Using dedicated software, radiographic analysis (to detect marginal bone level changes) and cast model analysis (to detect soft tissue vertical and horizontal changes) were performed.At the end of the study, patient satisfaction, using a VAS scale, was evaluated.Results: At the 36-month follow-up, 21 consecutive patients (9 men and 12 women with mean age of 63.7u00b114 years) with 25 implants were included in this study. All implants resulted clinically osseointegrated, stable, and showed no sign of infection. At baseline, interproximal radiographs revealed no bone defect around implants. After an initial minimal bone loss (0.09u00b10.144 mm), at the last follow-up, radiographic analysis showed a stable condition of bone remodeling (mean value: 0.09u00b10.08, range 0.0 to 0.5 mm). No statistically significant horizontal dimensional changes of the alveolar ridge were observed between each time points. Mean soft tissue levels significantly improved between baseline and T3 timepoints. The mean height of the mesial and distal papilla changes was u20130.18 u00b1 0.12 and -0.17 u00b1 0.09, respectively. The level of the labial gingival margin was -0.11 u00b1 0.063. Periodontal parameters never exceeded the physiological levels. Patient satisfaction was 9.02u00b1 2.4Conclusions: With the limitation of this preliminary trial, the analyzed minimal impact surgical and prosthetic approach allows to obtain encouraging results also in highly esthetically demanding cases even without any supplementary surgery. In fact, because of the insertion in a regenerated site and its peculiar collar shape, the implant can be inserted in a more proper midcrestal position. The absence of an AIJ at bone level eliminates the chronic inflammatory infiltrate and the associated crestal bone loss.
Author: Hilde Morales
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Objective:The aim of this study was to compare the behavior of peri-implant tissues in two different extra short implants design during osseointegration of crestal placement in maxilla dogs.Materials and Methods:Eight Short DM 5 x 4 mm (Bioner, Spain) delayed implants were placed in each hemimaxilla of 6 dogs at the bone crest level. Four implants of each design (big and small platform) were randomizedinstalled.After 12-week of healing period, histomorphometric analyses of the specimens were carried out to measure the crestal bone level values and the tissue thickness in theimplant shoulderportion. The data were compared using the one-way ANOVA statistical tests (u03b1= 5%).Results:In the microscopic analysis of thecrestal bone remodeling, the distance from the implant shoulder to the first bone-to-implant contact was higher for implants installed with small platform in the buccal aspect with statistical significance (P
Author: Mario Roccuzzo
Publisher: Quintessenz Verlag
ISBN: 3868675590
Category : Medical
Languages : en
Pages : 503
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Book Description
Popular demand for dental implants as a reliable long-term option to replace missing teeth has risen dramatically. However, situations remain that pose challenges to practitioners and the treatment process. Written by renowned clinicians and supported by cases contributed by expert practitioners, the present volume of the ITI Treatment Guide series highlights the integration and management of peri-implant soft tissues. It discusses soft-tissue management before and during implant placement and during supportive peri-implant therapy and addresses the techniques and materials used for peri-implant soft-tissue augmentation and replacement and for the treatment of peri-implant soft-tissue dehiscences. Volume 12 of the ITI Treatment Guides series offers clinicians a comprehensive overview of various evidence-based techniques and treatment approaches for use in daily practice, with a focus on current techniques and materials.
Author: Adriano Piattelli
Publisher: Woodhead Publishing
ISBN: 0081002882
Category : Technology & Engineering
Languages : en
Pages : 286
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Book Description
Bone Response to Dental Implant Materials examines the oral environment and the challenges associated with dental biomaterials. Understanding different in vivo and in vitro responses is essential for engineers to successfully design and tailor implant materials which will withstand the different challenges of this unique environment. This comprehensive book reviews the fundamentals of bone responses in a variety of implant materials and presents strategies to tailor and control them. - Presents a specific focus on the development and use of biomaterials in the oral environment - Discusses the basic science of the dental interface and its clinical applications - Contains important coverage on the monitoring and analysis of the dental implant interface
Author: Mohamed Hassan
Publisher: Springer Nature
ISBN: 3031455169
Category :
Languages : en
Pages : 165
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Book Description
Author: Schoichet Josu00e9 Jorge
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
The longevity and functionality of dental implants depends on both, osseointegration around the implant and the establishment of a soft tissue barrier which protects the underlying hard tissue structures and the implant itself.1 The healing of soft tissues around the trans-mucosal portion of an implant after surgery starts with the formation of a blood clot and the induction of an inflammatory process which leads to tissue formation and remodeling.2 Taking into account that mucosae healing, in an oral environment, is challenging due to the consistent exposure to microorganisms, the rapid formation of an efficient soft-tissue seal is therefore crucial for the establishment and maintenance of peri-implant tissue health status.3 In the case of implants in the anterior region, the esthetics of the implant prosthesis becomes critical to the acceptance of the implant treatment, therefore, soft tissue control is absolutely fundamental.1 In this context, in cases of indication of extraction of anterior teeth, the insertion of immediate implants has become a clinical routine for the implant dentist. When the parameters for implant placement into fresh alveoli are respected, the esthetic results are extremely satisfactory, reducing consultation time, promoting a positive psychological impact on the patient and the maintenance of peri-implant mucosa.4Furthermore, immediate loading can achieve primary stability by using the implant insertion torque of at least 40 Ncm.5 This technique has a failure rate similar to conventional implants6 with less alveolar bone crest loss.7 To achieve these results, the alveolar bone must be intact in a site with thick gingival biotype and adequate three-dimensional positioning of the implant in the alveolus.Immediate loading directly influences the soft tissue framework around the implant. The maintenance of the peri-implant tissue through the manipulation of the temporary implant-supported prothesis is quite important for gingival health and esthetics of the region where the implant was inserted.8However, the needs of patients are diverse and esthetics is an increasingly important demand. In clinical practice, not all patients can be submitted to extraction with immediate implant placement and loading. In cases of low predictability, when the placement of a temporary implant-supported prothesis jeopardizes the success of the immediate implant, how should one proceed to maintain the gingival structure?This is a case report that describes an alternative treatment for the healing and maintenance of the peri-implant mucosa in an esthetically significant region, through the use of a customized abutment to obtain an emergency profile when there is insufficient torque for immediate implant loading.
Author: Chen Andru00e9
Publisher:
ISBN:
Category :
Languages : en
Pages :
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BackgroundInformation on the molecular events occurring during early peri-implant wound healing, that is, during dynamic tissue conditions is scarce.Inflammatory perimplant wound healing express in regulatory cytokines may contribute to early events such as marginal bone remodeling. Different biomaterials are known to evoke different tissue reactionsI.Zirconia. titanium and acrylic are materials regularly used in implant dentistry but little is know about the quantification of cytokines expression that each one has.Aim/HypothesisWhen placing titanium dental implants, does the abutment material (titanium (T) compared to zirconia (Z) and(A) acrylic) have the same inflammatory/cytokine response to perimplant tissues, measured in IL1b and IL6 concentrations at different time frames ?Materials and methodsEight adult male sheep, receive 6 mandibular titanium, platform-switch implants (Biomet-Zimmeru00ae 4.1/3.5x8,5 mm height), three on each side, placed in the diastema, between incisors and premolars.Peri-implant crevicular fluid (PICF) was analyzed for cytokines expression.At the time of surgery each implant was randomly assigned, a two-piece healing abutment made from milled T, milled Z or milled A.PICF samples were take, at the day of surgery (1 hour after surgery was finished - baseline- BL), at 1 month (T1) and at three month (T3) with adsorbent paper (Periopaperu00ae).Samples were placed in eppendorf tubes, transported in dry ice and stored at -80.Interleukins (IL) 1b (IL1b) and 6 (IL6) were measured from validated ELISA kits (Raybiotechu00ae)Calibration Curve for IL6 and IL1b and spectrophotometry at 450 nm readings were made. We randomly duplicate and triplicate each sample for accuracyFor control group we measure the amount of IL1b and IL6 from periodontal crevicular fluid (PCF) sulcus of adjacent teeth (at BL and T3), and the amount of IL from blood samples immediately taken after first incision at BL. p values0.05 were considered statistically significant.ResultsFor IL6 at BL (p=0,597), T1 (p=0,497 ) and T3 (p=0,481), and forIL1b at BL (p=0,857), T1 (p=0, 357) and T3 (p=0,237) there were no statistically differences between T, Z and A, regarding changes in IL expression (p values0.05).For each material there were no statistical differences (Mann-Whitney) between BL and T3 for IL6, T (p=1,000); Z (p=0,857); A (p=0,095) andfor IL1b, T (p=1,000); Z (p=0,905); A (p=0,286) respectively (p values>0.05)There were no statistical differences between (PCF) and (PICF), at baseline (p=0.688) and at day 3 (p=1.000) for IL6 (p values>0.05)There were no statistical differences between (PCF) and (PICF), at baseline (T p=0.688, Zp=0.688,A p=1.000) and at day 3 (Tp=1.000, Zp=1.000,A p=0,125) for IL1b (p values>0.05)For T, Z and A there was significantly less expression of IL6 (p=0.0310.05) in PICF, at BL (1hour after), than the IL present in blood, at the time of incision.For IL1B there was significantly less expression for Z (p=0.0310.05) in PICF at BL (1 hour after), than IL present in blood, but not for A (p=0,3750,05) or T (p=0,2190,05)Conclusion and clinical implicationsRegarding expression of IL6 and IL1b from Bl to T3, T, Z and A have a similar behavior throw time, expressing the same amount of IL, than PIC of adjacent teeth, at similar time frame.For IL6 at BL, T, Z and A express less amount of IL, than the same IL present in blood.Z abutment have a significant inferior IL1b and IL6 expression than the IL present in the blood at BL. The inferior reaction triggered by Z abutments (measured in osteoclastic inducer IL1B) but not by A or T, may be the key to understand, if different materials have different marginal bone remodeling patterns in the first days of healing.
Author: Herekar Manisha
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Statement of problem: In immediate implants the major challenge is preservation of bone and peri-implant soft tissue, which provides long term function and esthetics.Purpose: To study the influence of platform switching on soft and hard tissue around immediately placed implants.Material and Methods: 20 immediate implants were divided in 2 groups and restored with matched and switched abutments. The amount of bone gain in area of jumping distance and the changes in buccopalatal bone width was assessed . Measurements of the peri-implant mucosa was done at implant placement, abutment placement and 1 month, 3 month, 6 month post abutment placement Results: Statistical analysis showed a bone gain at the time of stage II surgery (P = .048). 97.19% bone gain at the time of stage II surgery and was statistically significant. Platform matched abutments elicits statistically insignificant change in mesial and distal papilla level and buccal peri-implant mucosa level at different time interval.(p u2265 0.05). Platform switched abutment elicits statistically significant change in mesial and distal papilla level and buccal peri-implant mucosa level at different time interval. Conclusion: This study suggests that platform switching can provide increase in mesial and distal papilla and buccal peri-implant mucosa level along with bone remodeling around implant.
